Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
Evaluation Table
Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 3A: Critical Appraisal of Research
Full APA formatted citation of selected article. Article #1 Article #2 Article #3 Article #4
Shekelle, P. G. (2013, March 5). Nurse-Patient Ratios as a Patient Safety Strategy:A Systematic Review. Annals of Internal Medicine. https://web.p.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=1&sid=cfc25415-acc5-4567-a3a5-a1f70bc0735a%40redis
Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., & Ball, J. (2018). The association between Nurse Staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 1474–1487. https://doi.org/10.1111/jan.13564 Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing. https://watermark.silverchair.com/eurjcn0006.pdf? Redfern, O. C., Griffiths, P., Maruotti, A., Saucedo, A. R., & Smith, G. B. (2019). The association between nurse staffing levels and the timeliness of vital signs monitoring: A retrospective observational study in the UK. BMJ. https://bmjopen.bmj.com/content/9/9/e032157.long
Evidence Level *
(I, II, or III)
III II I
II
Conceptual Framework
ORDER HERE A PLAGIARISM-FREE PAPER HERE
Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**
Patient safety is greatly influenced by nurse staffing ratios.
It is based on the idea that more nurses on staff could result in better patient outcomes, such as a decline in in-hospital mortality.
Patient mortality is strongly impacted by the number of registered nurses (RN) and nursing assistants working each day. The premise that nurse staffing levels in acute specialized units are closely related to nurse-sensitive patient outcomes forms the basis of this article’s conceptual framework. Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
The quantity of nurses on duty, particularly the number of registered nurses (RNs) and nursing assistants (NAs), affects how quickly vital signs are monitored in medical and surgical wards.
Design/Method
Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). Systematic review • Longitudinal observational study with a retrospective design
• • This research set out to look at how different numbers of nurses on staff affected certain patient outcomes that nurses are especially sensitive to.
• Methodology based on historical records
Sample/Setting
The number and characteristics of
patients, attrition rate, etc. Included 87 articles and 15 new studies, but detailed characteristics not provided. • Between 2012 and 2015, 138,133 adult patients on general wards were included.
Searched nine online databases for English-language publications published between 2006 and 2017 for this systematic review and meta-analysis. Cross-sectional studies using big administrative databases were used in 35 of the papers.
• A big hospital in England has 538,238 shifts for nurses who are spread among the available 30,982 days for ward and 32 medical and surgical wards.
Major Variables Studied Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
List and define dependent and independent variables • Dependent – In-hospital death
• Independent – Nurse staffing ratios
• Dependent – Perinatal mortality
• Independent – Staffing schedules for RNs and CNAs on a daily basis
• Dependent – Impact of nurses on patient outcomes
• Independent – Ratios of nurses to patients
• Dependent – Daily rates of vital sign omissions and omissions due to tardiness
• Independent – Staffing ratios between registered nurses (RNs) and nursing assistants (NAs)
Measurement
Identify primary statistics used to answer clinical questions (You need to list the actual tests done). The information that is currently provided does not specifically specify the main data that are utilized to respond to clinical questions. Patient outcomes and shift-to-shift variations in registered nurses and certified nursing aides were examined using multilevel/hierarchical mixed-effects regression models. The most common statistical strategies for addressing clinical concerns are meta-analysis and systematic review. • Incidence rate ratios are the main statistical methods used to address clinical issues (IRR).
Data Analysis Statistical or Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
Qualitative findings
(You need to enter the actual numbers determined by the statistical tests or qualitative data). The article doesn’t offer any specific quantitative or qualitative information, only the results of a systematic review. In the first five days of a patient’s stay, each additional hour of RN care lowered mortality risk by 3 percent. A meta-analysis of 175,755 patients found that increasing nurse staffing reduced in-hospital mortality by 14%. • Observations that were late or missing were common, especially in individuals with high acuity. Lower rates of missing observations were linked to higher levels of RN employment.
Findings and Recommendations
General findings and recommendations of the research According to the systematic research, lower inpatient mortality rates are linked to higher nurse staffing levels. A causal link between nurse staffing levels and in-hospital deaths is supported by a longitudinal research conducted in a single hospital and a meta-analysis. The likelihood that a patient may die increases when there are fewer registered nurses on staff and more patients admitted per nurse. According to the systematic review and meta-analysis, increased nurse staffing levels are linked to lower mortality and better outcomes for patients who are nurse-sensitive. • In high-acuity patients, nurse and nursing assistant staffing affects vital sign monitoring. Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
Appraisal and Study Quality
(Describe the general worth of this research to practice.
What are the strengths and limitations of study?
What are the risks associated with implementation of the suggested practices or processes detailed in the research?
What is the feasibility of use in your practice? ) • Evidence level III denotes the systematic review.
• The systematic review design and causal link between nurse staffing and in-hospital mortality are the study’s strengths.
• The results’ generalizability is difficult to assess without sample and environment details.
• With an evidence level of II, a retrospective longitudinal cohort study is indicated.
• Regression models were used to examine associations, which is one of the study’s strengths.
• The study’s limitations include possible biases and the absence of data on nursing assistant staffing.
• • The systematic review and meta-analysis are of high quality, as indicated by the evidence level of I.
• The systematic review design, meta-analysis, and sizable sample size of the study are its merits.
• Potential biases in the included research and different settings are examples of limitations.
• Indicating a retrospective observational study, the evidence level is II.
• Large sample size and objective measurement of care omissions are two aspects of the study that stand out.
• Potential biases and differences in the contexts are examples of limitations. Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
Key findings
The most important conclusion is that adequate staffing of nurses correlates with lower in-hospital death rates. The main conclusions are that there is a higher probability of in-hospital death with decreased RN staffing and more patients admitted per RN. The main finding is that increased nurse staffing levels are linked to lower mortality and better patient outcomes for nurses. • The main conclusions are that nurse staffing levels are connected to adherence to vital sign monitoring standards, with increased RN staffing being associated with lower rates of missing observations. Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
ORDER TODAY
Outcomes
Thus, it follows that having more nurses on staff might help reduce in-hospital deaths. The conclusion is that keeping RN staffing levels adequate is essential to lower the risk of death during hospital admissions. As a result, raising nurse staffing ratios can have a positive effect on patients’ outcomes in acute specialty units. • The conclusion is that keeping RN staffing levels appropriate can increase the timeliness of vital sign monitoring, especially in high-acuity patients.
General Notes/Comments The inability to evaluate the study’s applicability to diverse healthcare settings is due to the absence of information regarding the sample and setting characteristics. • The study sheds light on how patient mortality during hospital admissions relates to RN staffing levels.
The systematic review and meta-analysis offer solid support for the hypothesis that nurse staffing and patient outcomes are related. • The study shows that timely vital sign monitoring is impacted by nurse staffing levels and is connected to objectively measured omissions in care. Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
Best Practice Proposal:
A best practice recommendation based on the critical evaluation of these publications is to maintain adequate nurse staffing levels in healthcare settings, especially for registered nurses. This could lower mortality, improve patient outcomes that are sensitive to nurses, and speed up vital sign monitoring. To ensure patient safety and high-quality treatment, the specific implementation of this practice should consider the particulars of the clinical environment and analyze the viability of increasing nurse staffing.
Evidence-Based Practice (EBP) is a lifelong problem-solving approach to the delivery of healthcare that integrates the best evidence from a body of research with a clinician’s expertise and a patient’s preferences and values to make the best decisions about patient care (Melnyk & Fineout-Overholt, 2023). EBP improves healthcare quality of care and patient outcomes as well as reduces healthcare costs. Specific EBP competencies for nurses can help organizations reduce healthcare costs as well as achieve high quality care (Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014). Although EBP has research backing the necessity of changes in current practices, many healthcare workers never implement the changes due to lack of organizational support, lack of skills and knowledge, and poor attitudes towards EBP (Kim, Stichler, Ecoff, Brown, Gallo, & Davidson, 2016). Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
The Triple aim was designed to improve healthcare by improving patients experience of care, health of the population and lowering healthcare costs. It is necessary that healthcare workers be willing to engage in EBP but if a nurse does not feel that their input or work is meaningful or valued, why would they want to exert effort into researching or implementing EBP (Sikka, Morath, & Leape, 2015). The Quadruple aim adds another goal to the triple aim by taking into consideration that the experience of providing care needs to be joyful and meaningful (Sikka, Morath, & Leape, 2015). It is basically stating that a worker needs to have a sense of accomplishment and importance in their daily work. The workforce needs to feel their work is valued, important and have a sense of accomplishment. Healthcare workers also need to feel safe and not overloaded when delivering quality care (Sikka, Morath, & Leape, 2015). Unsafe environments and overloaded workloads lead to burnout (Sikka, Morath, & Leape, 2015). Improving the experience of giving quality care will undoubtably increase more cooperation and involvement with implementing EBP. Nurse-Patient Ratios as a Patient Safety Strategy Assignment Paper
256160__module-2-journal-3-ebp_65423f679f4a0.pdf (3)
256160__EBP-on-Improving-Patient-Outcomes-and-Cost-Saving-though-Nurse_65440bb9baddc (4)
